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Hepatitis E: An emerging infection in high income countries
J E Arends1, V Ghisetti2, W Irving3
1Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands; Members of the European Study Group on Viral Hepatitis (ESGVH) of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID), Switzerland.
Summary
Hepatitis E virus (HEV) genotype 3 causes unexplained liver disease in Western countries. This review covers HEV GT3 virology, epidemiology, clinical aspects, and treatment in high-income nations.
Area of Science:
- Hepatology
- Virology
- Infectious Diseases
Background:
- Hepatitis E virus (HEV) genotype 3 is a significant cause of liver disease in Western countries.
- While often asymptomatic, HEV GT3 can lead to acute or chronic hepatitis, particularly in immunocompromised individuals.
- Extrahepatic manifestations of HEV GT3 infection are occasionally reported.
Purpose of the Study:
- To provide a comprehensive overview of Hepatitis E virus genotype 3.
- To discuss the virology, epidemiology, clinical presentation, and treatment of HEV GT3 infections.
- To highlight challenges in HEV GT3 diagnosis and management.
Main Methods:
- This is a review article, synthesizing existing knowledge on HEV GT3.
- Literature search on basic virology, epidemiology, clinical manifestations, and treatment strategies.
- Discussion of diagnostic methods, including limitations of antibody detection and advancements in molecular assays.
Main Results:
- HEV GT3 is an emerging cause of liver disease in high-income countries.
- Diagnostic accuracy of immunoassays for anti-HEV antibodies is moderate, especially in immunocompromised patients.
- A WHO international standard for HEV RNA detection by RT-PCR has been established.
Conclusions:
- HEV GT3 infections require increased recognition and understanding in clinical practice.
- Accurate diagnostics, including molecular methods, are crucial for managing HEV GT3.
- Further research and standardized diagnostic approaches are needed for effective HEV GT3 control.
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